Hospital-acquired gastroenteritis at a referral hospital in Gaborone, Botswana

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Henry Welch ◽  
David M. Goldfarb ◽  
Banno Moorad ◽  
Margaret Mokomane ◽  
Marek Smieja ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Severe Malnutrition ◽  
Oral Rehydration ◽  
History Of ◽  
Rehydration Solution ◽  
The Mean ◽  
Sub Saharan ◽  
Hospital Acquired ◽  
Monthly Incidence

Background: Hospital-acquired infections, including hospital-acquired gastroenteritis (HAGE), are well documented in Western countries but little is known about these infections in sub-Saharan Africa. Aim: To determine the incidence of and explore modifiable risk factors for HAGE. Methods: A prospective cohort study of children 72 hours after admission or upon admission after recent discharge for a non-GE illness. Children were followed until discharge to ascertain therapies used and adverse outcomes. Enteric pathogens were identified by multiplex PCR. Findings: Virtually all of the 32 children with HAGE were < 2 years (n=30, 94%) and most were male (n=19, 59%). Few had HIV infection (n=6, 19%), severe malnutrition (n=8, 25%), or a history of vitamin A use in the past 6 months (n=2, 6%). The mean monthly incidence of HAGE was 2.3 per 1000 patient days, and associated with the monthly number of community-acquired gastroenteritis (CAGE) admissions (IRR 1.02, 95% CI 1.00, 1.04, p=0.025). A stool pathogen was detected in 15/27 (56%) children, including norovirus (n=7, 26%) and rotavirus (n=5, 18%). Most children received oral rehydration solution (n=26, 81%), or IV fluids (n=9, 28%). Antibiotics were administered to 5 (16%) children. Two (6%) children with HAGE were admitted to the ICU and 4 (12%) died. Conclusions: We found HAGE was relatively common and associated with severe outcomes. The monthly incidence of HAGE was associated with CAGE admissions. Common pathogens included norovirus and rotavirus.

scholarly journals Prevalence and Correlates of Growth Failure in African Patients with Sickle Cell Disease: A Multinational Study

Blood ◽  
2017 ◽  
Vol 130 (Suppl_1) ◽  
pp. 971-971
Author(s):  
Laure Alexandre ◽  
Dapa Diallo ◽  
Aissata Tolo ◽  
Saliou Diop ◽  
Ibrahima Sanogo ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Growth Failure ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Cell Disease ◽  
History Of ◽  
The Mean ◽  
Male Sex ◽  
Sub Saharan

Abstract Introduction Growth failure has been a well-known complication of sickle cell disease (SCD) since the 70s. More recent studies show that the proportion of underweight children with SCD has decreased significantly, thanks to modern treatments (in particular hydroxyurea and iterative transfusions), with a tendency towards overweight and even obesity. However, most studies have been carried out in high-income countries, while 80% of the affected children are born in sub-Saharan Africa, where the environment and the medical care are entirely different. We carried out a case-control study nested in a multinational African cohort to study the growth of sickle cell children and the possible factors influencing growth failure. Methods We performed a case-control transversal study nested in the CADRE cohort that includes SCD patients from five African countries: Cameroon, Gabon, Côte d'Ivoire, Mali and Senegal. All children aged 5 to 21 years-old from this cohort were included in our study. Healthy controls were recruited among the patients' siblings or the children of health workers from each center. The main parameters studied were: medical history, height, weight, blood pressure; hemoglobin phenotype (SS, Sβ0, SC or Sβ +); complete blood count; hemolysis markers (LDH and bilirubin); microalbuminuria; echocardiographic parameters. The primary endpoint was growth failure, defined as a weight, height or BMI below the 5th percentile of the WHO growth charts. We described the frequency of growth failure according to hemoglobin phenotype, age and sex. Then we assessed by multivariate logistic regression in two SCD phenotypic groups (SS or Sβ0 and SC or Sβ +) the association between growth failure and the biological characteristics or the history of SCD-related complications. Results 2296 patients (1799 SS, 114 Sβ0, 287 SC, 96 Sβ+ patients and 287 controls were enrolled in Cameroon (n=735), Ivory Coast (n=380), Gabon (n=298), Mali (n=589) and Senegal (n=581). Overall, 48% of the patients were male and their median [interquartile range] age was 12 [8-16] years-old. Growth failure was diagnosed in 51% of SS, 58% of Sβ0, 44% of SC, 38% of Sβ+patients and 32% of controls, with deeper underweight than linear growth retardation. Beyond the age of 18, the mean BMI of SCD patients was again similar to that of controls in girls, but remained lower in boys, whereas the mean height was similar to that of controls regardless of sex (Figures a to d). Growth failure was more frequent in boys than in girls and maximal between 13 and 16 years-old (Figures e and f). In univariate analysis, the prevalence of growth retardation was associated with the country (highest in Senegal, lowest in Cameroon), age, male sex, hemoglobin phenotype, levels of anemia and hemolysis (p &lt;.0001 for all comparisons). After adjusting for age and the country, the prevalence of growth failure was significantly higher in SS-Sβ0 patients compared to controls (OR = 2.55 [1.83-3.56]) but not different between SC-Sβ+ patients and controls (1.35 [0.91-2.01]). In multivariate analysis, growth failure in SCD patients was positively associated with male sex (OR=1.89, 95%IC=1.56-2.28), [12-15] years age class (OR=2.31, 95%IC=1.75-3.07), SS or Sβ0 phenotypes (OR=2.06 and 2.27, 95%IC=1.26-3.36 and 1.22-4.21, respectively), icterus, leukocytes count, and microalbuminuria (OR = 1.4 [1.1-1.8]). It was negatively associated with parents' secondary or upper education, mean blood pressure and hemoglobin level (OR = 1.96 [1.55-2.47] for the first quartile of hemoglobin level vs others). No association was found between growth failure and the history of clinical SCD-related complications (osteonecrosis, leg ulcers, stroke, priapism, pulmonary hypertension defined by echocardiography and retinopathy). Conclusion In sub-Saharan Africa, growth failure occurs in more than half of the SCD children and concerns weight more than height. Its prevalence is particularly high in SS or Sβ0 patients and during adolescence, due to pubertal delay. Growth failure in SCD children is associated with male sex, anemia and high hemolysis markers independently of the hemoglobin phenotype, but is not independently associated with the occurrence of acute or chronic vascular complications of sickle cell disease, apart from microalbuminuria. However, the long-term consequences of growth failure in sickle cell disease should be evaluated in a longitudinal study. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Christianity in the Twentieth Century

2019 ◽  
Author(s):  
Brian Stanley
Keyword(s):  
Latin America ◽  
Racial Identity ◽  
Sub Saharan Africa ◽  
Central Importance ◽  
Regional Survey ◽  
History Of Christianity ◽  
The World ◽  
History Of ◽  
Sub Saharan ◽  
Different Parts

This book charts the transformation of one of the world's great religions during an age marked by world wars, genocide, nationalism, decolonization, and powerful ideological currents, many of them hostile to Christianity. The book traces how Christianity evolved from a religion defined by the culture and politics of Europe to the expanding polycentric and multicultural faith it is today—one whose growing popular support is strongest in sub-Saharan Africa, Latin America, China, and other parts of Asia. The book sheds critical light on themes of central importance for understanding the global contours of modern Christianity, illustrating each one with contrasting case studies, usually taken from different parts of the world. Unlike other books on world Christianity, this one is not a regional survey or chronological narrative, nor does it focus on theology or ecclesiastical institutions. The book provides a history of Christianity as a popular faith experienced and lived by its adherents, telling a compelling and multifaceted story of Christendom's fortunes in Europe, North America, and across the rest of the globe. It demonstrates how Christianity has had less to fear from the onslaughts of secularism than from the readiness of Christians themselves to accommodate their faith to ideologies that privilege racial identity or radical individualism.

Forced Labour in the “Gorgulho Years”: Understanding Reform and Repression in Rural São Tomé e Príncipe, 1945–1953

Itinerario ◽  
2014 ◽  
Vol 38 (1) ◽  
pp. 103-124 ◽  
Author(s):  
Alexander Keese
Keyword(s):  
Economic Change ◽  
Social Conditions ◽  
Sub Saharan Africa ◽  
History Of ◽  
Colonial Policies ◽  
Sub Saharan ◽  
Incomplete Images ◽  
Forced Labour ◽  
Sao Tome E Principe

The crossroads of nationalist historiographies in sub-Saharan Africa and of the history of developmentalist attempts that characterise the European late colonial states, have left us with very incomplete images of important trajectories. In the seemingly more “liberal” large colonial empires—notably the French and British—sails were set by 1945 towards a policy of investment and economic change. Some of the scholarly debates question whether this investment was genuine or just a last resort to avoid (rapid) decolonisation; others put the emphasis on inadequate routines of development implemented in these territories, many of which have apparently been continued since decolonisation.In this context, we encounter a clear lack of understanding about how decisions made by individual actors on the administrative level interacted with the larger panorama of social conditions in colonial territories, and of the consequences that these interactions had for the paths towards decolonisation. For a smaller empire such as the Belgian colony of Congo-Léopoldville, these processes are still more obscure; and for the colonies ruled by authoritarian metropoles, as in the cases of territories under Spanish and Portuguese rule, stagnation and absence of change are often taken for granted. In other words, these territories, which were under the rule of metropoles regarded as rather weak in economic terms, are treated as unrepresentative of the broader, European movement towards change in colonial policies. However, the conditions of change towards economic and social modernisation in this latter group of empires, even when inhibited by lack of funding and weak professionalisation of the administration, are frequently very telling for the broader range of challenges that the late colonial states faced.

Women in Gabon

2021 ◽  
Author(s):  
Claire H. Griffiths
Keyword(s):  
Central Africa ◽  
Early Period ◽  
Sub Saharan Africa ◽  
African Women ◽  
Female Population ◽  
History Of ◽  
Sub Saharan ◽  
Tropical Woods ◽  
New Research ◽  
Export Revenue

Gabon, a small oil-rich country straddling the equator on the west coast of Africa, is the wealthiest of France’s former colonies. An early period of colonization in the 19th century resulted in disease, famine, and economic failure. The creation of French Equatorial Africa in 1910 marked the beginning of the sustained lucrative exploitation of Gabon’s natural resources. Gabon began off-shore oil production while still a colony of France. Uranium was also discovered in the last decade of the French Equatorial African empire. Coupled with rich reserves in tropical woods, Gabon has achieved, since independence in 1960, a higher level of export revenue per capita of population than any other country in sub-Saharan Africa in the postcolonial era. However, significant inequality has characterized access to wealth through paid employment throughout the recorded history of monetized labor. While fortunes have been amassed by a minute proportion of the female population of Gabon associated with the ruling regime, and a professional female middle-class has emerged, inequalities of opportunity and reward continue to mark women’s experience of life in this little-known country of West Central Africa. The key challenge facing scholars researching the history of women in Gabon remains the relative lack of historical resources. While significant strides have been made over the past decade, research on women’s history in Francophone Africa published in English or French remains embryonic. French research on African women began to make a mark in the last decade of colonization, notably with the work of Denise Paulme, but then remained a neglected area for decades. The publication in 1994 of Les Africaines by French historian Catherine Coquery-Vidrovitch was hailed at the time as a pioneering work in French historiography. But even this new research contained no analysis of and only a passing reference to women in Gabon.

scholarly journals Potential of Spirulina Platensis as a Nutritional Supplement in Malnourished HIV-Infected Adults in Sub-Saharan Africa: A Randomised, Single-Blind Study

2011 ◽  
Vol 4 ◽  
pp. NMI.S5862 ◽  
Author(s):  
M. Azabji-Kenfack ◽  
S. Edie Dikosso ◽  
E.G. Loni ◽  
E.A. Onana ◽  
E. Sobngwi ◽  
...  
Keyword(s):  
Body Composition ◽  
Viral Load ◽  
Serum Albumin ◽  
Spirulina Platensis ◽  
Sub Saharan Africa ◽  
Nutritional Rehabilitation ◽  
Group A ◽  
The Mean ◽  
Sub Saharan ◽  
Group B

Background Malnutrition is a major global public health issue and its impact on communities and individuals is more dramatic in Sub-Saharan Africa, where it is compounded by widespread poverty and generalized high prevalence of human immunodeficiency virus (HIV). Therefore, malnutrition should be addressed through a multisectorial approach, and malnourished individuals should have access to nutritional rehabilitation molecules that are affordable, accessible, rich in nutrient and efficient. We thus assessed the efficacy of two affordable and accessible nutritional supplements, spirulina platensis versus soya beans among malnourished HIV-infected adults. Methods Undernourished patients, naïve of, but eligible to antiretroviral treatment (ART), aged 18 to 35 years were enrolled and randomly assigned to two groups. The first group received spirulina (Group A) as food supplement and the second received soya beans (Group B). Patients were initiated ART simultaneously with supplements. Food supplements were auto-administered daily, the quantity being calculated according to weight to provide 1.5 g/kg body weight of proteins with 25% from supplements (spirulina and soya beans). Patients were monitored at baseline and followed-up during twelve weeks for anthropometric parameters, body composition, haemoglobin and serum albumin, CD4 count and viral load. Results Fifty-two patients were enrolled (Group A: 26 and Group B: 26). The mean age was 26.4 ± 4.9 years (Group A) and 28.7 ± 4.8 (Group B) with no significant difference between groups ( P = 0.10). After 12 weeks, weight and BMI significantly improved in both groups ( P < 0.001 within each group). The mean gain in weight and BMI in Group A and B were 4.8 vs. 6.5 kg, ( P = 0.68) and 1.3 vs. 1.90 Kg/m2, ( P = 0.82) respectively. In terms of body composition, fat free mass (FFM) did not significantly increase within each group (40.5 vs. 42.2 Kg, P = 0.56 for Group A; 39.2 vs. 39.0 Kg, P = 0.22 for Group B). But when compared between the two groups at the end of the trial, FFM was significantly higher in the spirulina group (42.2 vs. 39.0 Kg, P = 0.01). The haemoglobin level rose significantly within groups ( P < 0.001 for each group) with no difference between groups ( P = 0.77). Serum albumin level did not increase significantly within groups ( P < 0.90 vs. P < 0.82) with no difference between groups ( P = 0.39). The increase in CD4 cell count within groups was significant ( P < 0.01 in both groups), with a significantly higher CD4 count in the spirulina group compared to subjects on soya beans at the end of the study ( P = 0.02). Within each group, HIV viral load significantly reduced at the end of the study ( P < 0.001 and P = 0.04 for spirulina and soya beans groups respectively). Between the groups, the viral load was similar at baseline but significantly reduced in the spirulina group at the end of the study ( P = 0.02). Conclusion We therefore conclude in this preliminary study, firstly, that both spirulina and soja improve on nutritional status of malnourished HIV-infected patients but in terms of quality of nutritional improvement, subjects on spirulina were better off than subjects on soya beans. Secondly, nutritional rehabilitation improves on immune status with a consequent drop in viral load but further investigations on the antiviral effects of this alga and its clinical implications are strongly needed.

Rotavirus

2021 ◽  
Author(s):  
Sultan Mahmood
Keyword(s):  
Rna Virus ◽  
Sub Saharan Africa ◽  
Oral Rehydration ◽  
Degree Of Protection ◽  
Rotavirus Vaccines ◽  
Increased Risk ◽  
Hygiene Measures ◽  
Primary Means ◽  
Sub Saharan ◽  
Health System Responsiveness

Rotavirus is a double-stranded RNA virus that causes vomiting and diarrhea among children under 5 years. The main cause of mortality from rotavirus gastroenteritis (RVGE) is dehydration if not corrected appropriately with oral rehydration salts (ORS). Though the prevalence of RVGE is similar across countries and socio-economic groups, the higher mortality in Sub-Saharan Africa and South Asia is presumably due to poor awareness and poor health system responsiveness rather than poor hygiene. Enzyme immunoassays are the most commonly used tools for diagnosis of RVGE from stool samples. ORS and zinc remain the mainstay of treatment. Water, sanitation and hygiene measures did not appear to be very effective leaving vaccination among young children as the primary means of prevention. 4 WHO prequalified live attenuated, oral vaccines are available with different efficacy in high- versus low-mortality countries. There is a high degree of protection in countries with low RV mortality, and lower protection in countries with high RV morbidity and more fatalities. Rotavirus vaccines were associated with intussusception, though larger trials failed to establish increased risk in vaccinated groups compared to placebo recipients.

The History of Romantic Love in Sub-Saharan Africa: between Interest and Emotion

2011 ◽  
Author(s):  
Megan Vaughan
Keyword(s):  
Romantic Love ◽  
Sub Saharan Africa ◽  
Historical Study ◽  
History Of ◽  
Political Project ◽  
Sub Saharan ◽  
Theoretical Issues

This chapter looks at the history of romantic love in Sub-Saharan Africa. This text comes from a lecture given at the British Academy's 2009 Raleigh Lecture on History. This text attempts to explore some of the methodological and theoretical issues involved in an historical study of love in Africa. It argues that romantic love in Africa is not simply an extension of an imperialist cultural and political project and that emotional regimes cannot be divorced from economic circumstances. It explains that though the configurations of interest and emotion take specific forms in African societies, there is nothing peculiarly African about the evident need of individuals to balance realism and idealism in their emotional lives.

scholarly journals Recurrent Collection of Drosophila melanogaster from Wild African Environments and Genomic Insights into Species History

2019 ◽  
Vol 37 (3) ◽  
pp. 627-638 ◽  
Author(s):  
Quentin D Sprengelmeyer ◽  
Suzan Mansourian ◽  
Jeremy D Lange ◽  
Daniel R Matute ◽  
Brandon S Cooper ◽  
...  
Keyword(s):  
Drosophila Melanogaster ◽  
Demographic History ◽  
Central Africa ◽  
Model Organism ◽  
Sub Saharan Africa ◽  
Wilderness Areas ◽  
Southern Central ◽  
History Of ◽  
Sub Saharan ◽  
Improved Model

Abstract A long-standing enigma concerns the geographic and ecological origins of the intensively studied vinegar fly, Drosophila melanogaster. This globally distributed human commensal is thought to originate from sub-Saharan Africa, yet until recently, it had never been reported from undisturbed wilderness environments that could reflect its precommensal niche. Here, we document the collection of 288 D. melanogaster individuals from multiple African wilderness areas in Zambia, Zimbabwe, and Namibia. The presence of D. melanogaster in these remote woodland environments is consistent with an ancestral range in southern-central Africa, as opposed to equatorial regions. After sequencing the genomes of 17 wilderness-collected flies collected from Kafue National Park in Zambia, we found reduced genetic diversity relative to town populations, elevated chromosomal inversion frequencies, and strong differences at specific genes including known insecticide targets. Combining these genomes with existing data, we probed the history of this species’ geographic expansion. Demographic estimates indicated that expansion from southern-central Africa began ∼13,000 years ago, with a Saharan crossing soon after, but expansion from the Middle East into Europe did not begin until roughly 1,800 years ago. This improved model of demographic history will provide an important resource for future evolutionary and genomic studies of this key model organism. Our findings add context to the history of D. melanogaster, while opening the door for future studies on the biological basis of adaptation to human environments.

scholarly journals Glimmering Utopias: 50 Years of African Film

2010 ◽  
Vol 45 (3) ◽  
pp. 147-159 ◽  
Author(s):  
Cassis Kilian
Keyword(s):  
Sub Saharan Africa ◽  
Post Colonial ◽  
African Film ◽  
Feature Films ◽  
History Of ◽  
Sub Saharan ◽  
The 1960S

The history of African film began in the 1960s with the independence of the colonies. Despite all kinds of political and economic difficulties, numerous films have been made since then, featuring wide-ranging processes of consolidation, differentiation and transformation which were characteristic of post-colonial sub-Saharan Africa. However, these feature films should not merely be viewed as back references to specifically African problems. The glimmering fictions are imagination spaces. They preserve ideas about how the post-colonial circumstances should be approached. Seen from this perspective, the history of African film may be studied as a history of African utopias.

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